Our doctor's will be providing Sioux Falls and surrounding areas a dependable source to turn to regarding health and wellness. They will be sharing their knowledge and providing insight to popular health topics, wellness and more.

Monday, January 30, 2017

South
Dakota follows a tort, rather than a no-fault system. This means that someone
must be considered to be at fault, and that person's policy must pay for any
and all damages. HOWEVER, that does not mean that you should not open
claims with YOUR auto insurance. Why? By opening claims with your auto
insurance, you will be ensuring that you are being protected from the at-fault
(liability) insurance refusing to pay your bills or offering a settlement that
does not cover everything you’ve already paid.

After
an accident:

Contact YOUR
auto-insurance. By paying your monthly premium, you have essentially hired
this company to help you after an accident. Not only will the help you fix your
car, but there is medical pay coverage to help ensure you are protected as
well.

By setting up a medical claim with your insurance,
you medical bills will be paid up-front with no money out of your pocket until
your coverage has been exhausted.

Your insurance company will work to be
reimbursed from the at-fault insurance. This saves you the hassle of having to
negotiate a settlement and also protects you from settlements that are too low
to cover your bills

After
YOUR insurance’s medical pay is exhausted, you private health insurance is your
best option. Much like submitting claims to your auto insurance, submitting
to your private health insurance will ensure your bills are being paid up
front, and they will work to be reimbursed by the at-fault insurance.

You will likely be responsible for any co-pays,
deductibles, co-insurance, and out of pocket maximums. You will have to
negotiate these expenses into your settlement from the at-fault insurance.

If you have
exhausted your medical pay and your private health insurance benefits, then you
would begin sending bills to the at-fault insurance.

While they may be responsible for all damages
caused in the accident; this is not an ideal situation.

They will not pay until you’ve been released
from medical care in relation to the accident. Depending on the severity of the
accident, this may not be for a long time, causing you bills to stack up. Many
providers may not be willing to sit on the balance and ask that you pay out of
pocket for your care.

Once you’ve been released, they will try to make
you settle. This amount would likely NOT cover all the expenses you’ve incurred
during your care.

There is a chance that the at-fault insurance
will try to fight against paying the bills. At that point, you would need to
hire an attorney.

Opening a medical claim with YOUR
insurance is always the safest route to ensure your bills are getting paid and
you are not burdened with dealing with the at-fault insurance company. By
paying your monthly premiums, they are obligated to help you with your
expenses. If they recommend sending bills to the at-fault insurance, insist on
opening a medical claim directly with them. If you continue issues, we would be
happy to call your insurance company with you and help you get the claim set
up.